Adverse Event Reporting
| VAERS ID | 1496657 |
|---|---|
| Gender | Male |
| Age | 81 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EY4834 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-25 |
| Onset | 2021-06-25 |
| Condition | Hospitalized Died |
Symptoms
- Pyrexia
- Vomiting
- Abdominal pain
- Oxygen saturation decreased
- Pneumonia
- Body temperature
- Oxygen saturation
- Acute respiratory failure
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Cerebral infarction; Convulsion; Emphysema; Heart disease, unspecified; Lung cancer
Other Medications
WARFARIN
Previous Vaccinations
Allergies
Laboratory Data
Test Date: 20210625; Test Name: Body temperature; Result Unstructured Data: Test Result:36.
6 Centigrade; Comments: before vaccination; Test Date: 20210627; Test Name: SpO2; Result Unstructured Data: Test Result:decreased; Test Date: 20210627; Test Name: SpO2; Result Unstructured Data: Test Result:around 88 %
Write-up
SpO2 decreased; Pneumonia; Acute respiratory failure; pyrexia; vomited; abdominal pain; This is a spontaneous report from a contactable physician received from the Regulatory authority.
Regulatory authority report number is v21118328.
A 81-year-old male patient received the second dose of bnt162b2 (COMIRNATY), via an unspecified route of administration (at the age of 81-year-old) on 25Jun2021 13:30 (Lot Number: EY4834; Expiration Date: 31Aug2021) as single dose for covid-19 immunisation.
Medical history included heart disease, cerebral infarction, previous convulsion (stopped on unspecified date), emphysema and lung cancer.
Concomitant medication included warfarin.
The patient previously received the first dose of bnt162b2 (COMIRNATY) for covid-19 immunization.
The patient was an 81-year and 2-month-old male.
Body temperature before vaccination was 36.
6 degrees centigrade.
The patient experienced pneumonia (death, hospitalization from 27Jun2021) on 25Jun2021 15:30, acute respiratory failure (death, hospitalization from 27Jun2021) on 25Jun2021 15:30, spo2 decreased (hospitalization from 27Jun2021) on 27Jun2021, abdominal pain on 25Jun2021 15:30, vomited on 26Jun2021, pyrexia on 27Jun2021.
The clinical course was as follows: On 25Jun2021 at 15:30 (2 hours after the vaccination), the patient experienced pneumonia and acute respiratory failure.
On 02Jul2021 (7 days after the vaccination), the outcome of the events was fatal.
It was not reported whether autopsy was done.
On 25Jun2021 at 13:30 (the day of vaccination), the patient received the vaccination at the facility.
Around 15:30, abdominal pain developed.
On 26Jun2021 around 00:00 (1 day after the vaccination), the patient vomited a large amount of food residue.
On 27Jun2021 around 00:00 (2 days after the vaccination), the SpO2 decreased.
With oxygen administration at 10L, the SpO2 was around 88%, and the patient was transported by ambulance to the reporting hospital.
He was admitted to the hospital for pneumonia and acute respiratory failure.
The patient had pyrexia and received antibiotics since admission.
Oxygen administration was performed with an open face mask.
On 02Jul2021 (7 days after the vaccination), the level declined, and endotracheal intubation was performed.
Although mechanically ventilated, the patient died at 12:13.
The reporting physician classified the events as serious (death) and assessed the causality between the events and BNT162b2 as unassessable.
Other possible causes of the events such as any other diseases were emphysema and lung cancer.
The reporting physician commented as follows: The patient died of pneumonia.
The outcome of the events pneumonia and acute respiratory failure was fatal, others was unknown.
The patient died on 02Jul2021 12:13 due to events pneumonia and acute respiratory failure.
It was not reported if an autopsy was performed.
; Reported Cause(s) of Death: Pneumonia; Acute respiratory failure